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Neurogenic Bladder

What is a neurogenic bladder?

The muscles and nerves of the urinary system work together to hold and release urine at the right time. Nerves carry messages between the bladder and the spinal cord and brain. The messages tell the bladder muscles to either tighten or release. With neurogenic bladder, these nerves don’t work the way they should.

What causes neurogenic bladder?

These are some possible causes of neurogenic bladder:

Diabetes

Infections

Accidents that cause injury to the brain or spinal cord

Genetic nerve problems

Heavy metal poisoning

Birth defects that affect the spinal cord

Brain or spinal cord tumors

Stroke

Herniated disks

Multiple sclerosis

Parkinson disease

What are the symptoms of neurogenic bladder?

These are the most common symptoms of neurogenic bladder:

Urinary tract infection (UTI)

Kidney stones

Unable to control urine (urinary incontinence)

Small amount of urine when urinating

Urinary frequency and urgency

Dribbling urine

Loss of feeling that the bladder is full

Unable to urinate

The symptoms of neurogenic bladder may look like other conditions. Always talk with a healthcare provider for a diagnosis.

How is neurogenic bladder diagnosed?

If your healthcare provider thinks you may have neurogenic bladder, he or she will want to check your brain, spinal cord, and bladder. He or she will review your health history and do a physical exam. Other tests may include:

X-rays of the skull and spine. This imaging test uses invisible energy beams to make images of tissues, bones, and organs.

Imaging tests of the bladder and ureters

Ultrasound (sonography). This imaging test uses sound waves to create images of the organs on a computer screen.

Cystoscopy. Your healthcare provider puts a thin, flexible tube and viewing device in through the urethra to examine the urinary tract. It checks for structure changes or blockages, such as tumors or stones.

Tests that are done by filling the bladder, such as urodynamics. These tests show how much the bladder can hold. They also check to see if it fully empties.

How is neurogenic bladder treated?

Treatment for neurogenic bladder depends on the cause. It is aimed at preventing kidney damage and may include:

Medicines

Emptying the bladder with a catheter at regular times

Preventive antibiotics to reduce infection

Placing an artificial cuff around the neck of the bladder which can be inflated to hold urine and deflated to release it

Surgery to remove stones or blockages

Botulinum toxin shots (injections) into the bladder muscle

Placing an electrical device to stimulate or slow down bladder activity

What are possible complications of a neurogenic bladder?

The following are often linked to a neurogenic bladder:

Urine leakage. This often happens when the muscles holding urine in don't get the right message.

Urine retention. This happens if the muscles holding urine in don't get the message that it's time to pass urine.

Damage to the tiny blood vessels in the kidney. This may happen if the bladder becomes too full and urine backs up into the kidneys. This causes extra pressure. It may lead to blood in the urine and kidney failure.

Infection of the bladder, ureters, or kidneys. This often results from urine that is held too long before it’s passed out of the body.

Key points about neurogenic bladder

With neurogenic bladder, the nerves that carry messages back and forth between the bladder and the spinal cord and brain don’t work the way they should.

Common symptoms include dribbling urine, loss of feeling that the bladder is full, and being unable to control urine (urinary incontinence).

Damage or changes in the nervous system and infection can cause neurogenic bladder.

Treatment is aimed at preventing kidney damage. It may include medicine, urinary catheters, antibiotics to reduce the chance of infection, and in severe cases, surgery.